ATKINSON v. LUITPOLD PHARMACEUTICALS, INC.

CourtDistrict Court, E.D. Pennsylvania
DecidedMarch 23, 2020
Docket2:19-cv-00277
StatusUnknown

This text of ATKINSON v. LUITPOLD PHARMACEUTICALS, INC. (ATKINSON v. LUITPOLD PHARMACEUTICALS, INC.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
ATKINSON v. LUITPOLD PHARMACEUTICALS, INC., (E.D. Pa. 2020).

Opinion

THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

MELANIE ATKINSON CIVIL ACTION

Plaintiff,

v. NO. 19-277 LUITPOLD PHARMACEUTICALS, INC., AMERICAN REGENT, INC., DAIICHI SANKYO, INC., DAIICHI SANKYO CO., LTD., AND VIFOR PHARMACEUTICALS MANAGEMENT, LTD., Defendants.

OPINION Plaintiff Melanie Atkinson brings negligence, fraud, strict liability, breach of warranty, and breach of consumer protection law claims following purported adverse effects she suffered after receiving injections of Injectafer, a medication prescribed to treat iron deficiency anemia. Defendants American Regent, Inc., formerly known as Luitpold Pharmaceuticals, Inc.,1 Daiichi Sankyo, Inc., and Daiichi Sankyo US Holdings, Inc. (collectively, “Defendants”) move to dismiss most of the Complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). I. FACTS2 Injectafer is an iron replacement injection medication brought to market in the United States by Defendants for the treatment of iron deficiency anemia (“IDA”) in adult patients who have intolerance to oral iron. The injection is to be administered intravenously in two doses separated by at least seven days.

1 Effective January 1, 2019, Luitpold Pharmaceuticals, Inc. merged with American Regent, Inc..

2 These facts are drawn from the Complaint and, for the purposes of the motion to dismiss, will be taken as true. See Kost v. Kozakiewicz, 1 F.3d 176, 183 (3d Cir. 1993). Injectafer is one of several products available for intravenous iron but is the only such product available in the United States formulated with the unique ferric carboxymaltose (“FCM”) compound. FCM can cause a condition called severe hypophosphatemia (“Severe HPP”). Hypophosphatemia is an abnormally low level of phosphate in a person’s blood, and the condition can be mild, moderate, severe, or persistent. Severe HPP has dangerous effects

including muscle weakening, fatigue, severe nausea, and possible medical complications including cardiac arrest, respiratory failure, arrhythmias, and rhabdomyolysis (muscle breakdown). Prior to its approval in the United States, FCM was available on the European and other markets under the brand name Ferinject—designed, manufactured, promoted, and sold by Defendant Vifor Pharmaceuticals. (Vifor licensed and continues to license FCM to all other Defendants.) During FCM’s presence on the European and United States markets, dozens of case reports and pieces of medical literature emerged that revealed the link between FCM and Severe HPP. The studies, of which Defendants were on notice, revealed an increasing number of

case reports of intravenous-iron patients developing Severe HPP. In one study, all 18 cases of severe and life-threatening HPP developed after administration of FCM. In another study, of the 78 patients taking FCM, 51% developed HPP, including 13% with Severe HPP. Defendants also had knowledge of the link between Injectafer and Severe HPP from their own clinical studies. When Luitpold Pharmaceuticals, Inc. (“Luitpold”) first submitted a New Drug Application for Injectafer to the Food and Drug Administration (“FDA”) in 2006, it received a non-approvable letter in response due to the FDA’s clinical safety concerns. Luitpold applied again in September 2007 and received another non-approvable letter, which cited “clinically important hypophosphatemia” as a concern. Injectafer eventually received FDA approval, and in 2013 Defendants brought Injectafer to the United States market. Since then, Injectafer’s label has at all times omitted any reference to “Severe HPP” or “clinically important hypophosphatemia.”3 HPP is not listed in the warning sections or in any kind of “black box” warning, but instead is listed as an “adverse reaction” occurring in less than two percent of patients. From July 2013 until January 2018, the Patient Information leaflet

referred to “asymptomatic reductions in blood phosphorus.” In January 2018, Defendants removed the term “asymptomatic” and simply listed “low levels of phosphorous in your blood” in the leaflet. The “Adverse Reactions in Clinical Trials” section of the labeling refers to “transient decreases in laboratory blood phosphorous levels (< 2 mg/dl).” The labeling makes no reference to clinical conditions associated with Severe HPP, including cardiac arrest, respiratory failure, arrhythmias, and rhabdomyolysis (muscle breakdown). The labeling also does not reference FCM’s known effect on the FGF23 hormone, which is associated with a decrease in blood phosphorous and can induce HPP. Plaintiff, a Texas resident, was prescribed Injectafer for the treatment of her IDA at the

Medical Clinic of Houston in Houston, Texas. She received her first Injectafer injection at the clinic on or around October 20, 2016. After that injection, Plaintiff’s blood phosphate levels dropped to 1.0 mg/dl, as measured on November 21. She was subsequently diagnosed with HPP, was hospitalized multiple times, and suffered from severe nausea, severe weakness and pain, and severe and constant fatigue. She took a leave of absence from work and was only able to return

3 Defendants have attached to their motion to dismiss a copy of the Injectafer Prescribing Information from July 2013, which they allege was in effect at the time of Plaintiff’s prescription. “[A] court may consider any undisputedly authentic document that a defendant attaches as an exhibit to a motion to dismiss if the plaintiff’s claims are based on the document” without converting a motion to dismiss into one for summary judgment. Pension Benefit Guar. Corp. v. White Consol. Indus., 998 F.2d 1192, 1196 (3d Cir. 1993). Neither party disputes the authenticity of the Prescribing Information. Given that Plaintiff’s Complaint challenges Injectafer’s labeling, warning, and patient information, the Prescribing Information may be considered in ruling on Defendants’ motion to dismiss. after several months on limited duties. Plaintiff filed this suit, alleging that she suffered and likely will continue to suffer severe and permanent injuries and damages as a result of taking Injectafer. Defendants have now moved to dismiss all claims, in whole or in part. II. LEGAL STANDARDS When evaluating a complaint on a motion to dismiss factual allegations are scrutinized

under Rules 8(a) and 12(b)(6) to determine if the allegations and inferences proposed from those allegations are plausible. See Ashcroft v. Iqbal, 556 U.S. 662, 683 (2009). “To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” See id. at 678 (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). “In light of Twombly, ‘it is no longer sufficient to allege mere elements of a cause of action; instead a complaint must allege facts suggestive of [the proscribed] conduct.’” Great W. Mining & Mineral Co. v. Fox Rothschild LLP, 615 F.3d 159, 177 (3d Cir. 2010) (quoting Phillips v. Cty. of Allegheny, 515 F.3d 224, 233 (3d Cir. 2008)). “[R]ote recitals of the elements

of a cause of action, legal conclusions, and mere conclusory statements” are disregarded. James v. City of Wilkes-Barre, 700 F.3d 675, 679 (3d Cir. 2012).

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ATKINSON v. LUITPOLD PHARMACEUTICALS, INC., Counsel Stack Legal Research, https://law.counselstack.com/opinion/atkinson-v-luitpold-pharmaceuticals-inc-paed-2020.